Hospitals with NO nurse anesthetists

  1. If there are any Wisconsin CRNAs here, or other CRNAs in other states that can shed some light on this situation... I need an explanation! :uhoh21:
    I'm soon to be a nursing student in Milwaukee this fall. I called Aurora Sinai Hospital for shadowing experiences of a CRNA. The lady I talked to said that Sinai no longer "uses" nurse anesthetists, nor does St. Francis and another Aurora hospital in the area!
    I'm confused, how can THREE hospitals in one city NOT "use" nurse anesthetists? Has anyone else experienced this? Could I have NOT fully understand what the lady was saying? The only thing I could think of is that they don't do surgeries or use some other type of anesthesia provider (AAs or something).
    What do you all think?
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  2. 18 Comments

  3. by   pnurseuwm
    Okay, I just called the hospital back and they say that they only use anesthesiologists. Isn't that awfully expensive?
    The lady told me that I should "reconsider" my career aspirations. Does anyone else know of a group of hospitals that JUST use anesthesiologists?
  4. by   UCDSICURN
    See below.

    Donn C.
    Last edit by UCDSICURN on May 26, '04
  5. by   loisane
    Quote from UCDSICURN
    Reason being, here in California CRNA's need to be "supervised" ....

    Donn C.

    It is my understanding that there is no state in the US where CRNAs "need" to be supervised. It is always a choice, made for various reasons.

    There is alot of misinformation out there. Including the receptionist (or whoever) telling you to reconsider nurse anesthesia. What does she know? Don't buy into it.

    loisane crna
  6. by   christinemj
    Head over to La Crosse and you'll find someone to shadow......
  7. by   yoga crna
    Quote from UCDSICURN
    Yep...several...just depends where you go. The hospital I used to work at uses MDA's exclusively. Reason being, here in California CRNA's need to be "supervised" and the hospital was very small, only two OR's. It wouldn't be cost effective for them to pay for an MDA to supervise 2 CRNA's in the rare (This was pretty rare.) instance that both OR's were going at the same time.

    Donn C.
    Donn,
    Whatever gave you the idea that CRNAs have to be supervised in California? That is totally inaccuate information, but I would like to know where you got it? Check the California Nurse Practice Act--Nurse Anesthetist section, which is THE LAW for nurse anesthetists in California.

    By the way, there are many hospitals in many areas that are MDA only. That is their right, there are many exclusive contracts that are in effect. But with economics of healthcare changing, look for a different direction.

    Also, the person who is giving career advise does not know what she is talking about. Nurse anesthesiology is one of the best and most sought after careers today and will continue to be in the future. That comes from the federal government.

    YogaCRNA
  8. by   UCDSICURN
    See below.

    Donn C.
    Last edit by UCDSICURN on May 26, '04
  9. by   yoga crna
    Quote from UCDSICURN
    The "need" reference was in regards to opting out/Medicare Part A reimbursement. To my knowledge, correct me if I'm wrong, California has yet to opt out of the supervision requirement regarding Medicare Part A reimbursement.

    Donn C.
    Donn,
    What exactly does Part A Medicare reimbursement mean and what does it have to do with California state law? I know the answer, do you? I am not trying to be arrogant here, but I believe you are a student and should be able to research this question and have the correct answers to be able to answer critics of our profession and have a practical explanation. Before you research the answer, remember that "Medicare reimbursement and legal-practice issues are two entirely different topics".
    Yoga
  10. by   loisane
    Quote from UCDSICURN
    The "need" reference was in regards to opting out/Medicare Part A reimbursement. To my knowledge, correct me if I'm wrong, California has yet to opt out of the supervision requirement regarding Medicare Part A reimbursement.

    Donn C.
    Oh DEAR, now people think that supervision is required in non-opt out states!! What misinformation there is out there.

    Good answer, Yoga. We must all never tire of correcting the lies and misinformation that are spread about us. It is a constant, but important battle.

    loisane crna
  11. by   UCDSICURN
    i was obviously confused, courtesy of the asa statement on the anesthesia care team and i took some hearsay , which was obviously inaccurate, as gospel.

    this is from a legal brief from the aana web page:

    "medicare does not require these (reference to asa statement) as a standard of care. medicare has no requirement of anesthesiologist supervision and will reimburse crnas who are not supervised by any physician if they meet the appropriate requirements."

    i also found this:

    the laws of every state permit crnas to work directly with a physician or other authorized health care professional without being supervised by an anesthesiologist. the joint commission on accreditation of healthcare organizations (jcaho) does not require anesthesiologist supervision of crnas nor does medicare.


    i now consider myself re-educated and less ignorant now. seriously, lois and yoga, i appreciate you setting me straight.

    donn c.
  12. by   JimmyMallo
    it's all about what group has the contract. Here in austin, St. David's has three hospitals and Seton has 3. St. Davids uses a medical group with NO CRNA's and Seton uses a group that has more CRNA's than MDA's. No rhyme or reason, just that the group at St. David's has enough MDA's to caver all cases where Seton does alot more cases and so has more need for anethesia services. BTW if you talk to a member of the St. David's group they will tell you MDA only is the only way to go. Talk to Seton and they say CRNA's are a godsend. Also, it you ask most people they would prefer to go to seton for major surgery, or so it seems from the people I talk to, and I WORK for St. David's right now. Bottom line, there are plenty of jobs to go around :hatparty:
  13. by   pnurseuwm
    Thank you for the responses and encouragement guys! I will continue to research the world of nurse anesthesia. This forum is a valuable resource :hatparty:
  14. by   user69
    [font='times new roman']can a crna practice without any md involved? specifically doing something like pain management on a private basis, or do they always have to work in cooperation with some licensed physician?

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